Ulcerative colitis treatment has expanded dramatically with anti-TNF agents, anti-integrin therapies, anti-IL-23 agents, JAK inhibitors, and S1P modulators all approved for UC. Despite this progress, many patients still experience refractory disease or require multiple medication trials. Research continues into novel mechanisms and personalized approaches. For patients with ulcerative colitis, clinical trials for ulcerative colitis offer access to investigational therapies. This guide covers how to find UC trials, active research areas, and resources.
Categories of UC trials
Active ulcerative colitis trials in 2026 include:
Selective IL-23 antagonists: Risankizumab approved for UC; others in development.
JAK inhibitors: Tofacitinib and upadacitinib approved; next-generation more selective JAK inhibitors in trials.
S1P modulators: Etrasimod approved; other S1P modulators in development.
TL1A antagonists: Novel target with promising early data; multiple agents in development.
Combination biologic therapies: Trials testing combinations to overcome single-agent failure.
Microbiome therapies: Specific microbial consortia, FMT for UC.
Where to find UC trials
Same as Crohn’s disease — Crohn’s & Colitis Foundation, academic IBD centers, ClinicalTrials.gov. See our Crohn’s disease trials guide for resource details.
Typical eligibility for UC trials
Common inclusion criteria:
- Moderate to severe UC (Mayo score in specific range)
- Confirmed diagnosis with endoscopic and histologic confirmation
- Specific extent of disease (some trials require pancolitis)
- Stable medications for specified period
Common exclusion criteria:
- Active infection
- Crohn’s disease (separate trials)
- Recent major surgery
- Pregnancy
Frequently Asked Questions
Are biologic-naive UC trials available?
Yes. Trials enroll across treatment lines.
What about acute severe UC trials?
Less common given the urgent nature of acute severe UC. Some trials test rapid-acting therapies.
Are colectomy patients excluded?
Generally yes. Most UC trials require intact colon.
How does mucosal healing endpoint work?
Most modern UC trials use endoscopic and histologic remission as primary endpoints, requiring repeat endoscopy.
Can I be in a UC trial while pregnant?
No. Pregnancy is excluded from most trials.
The bottom line on UC trials
UC research is active with multiple novel mechanisms in development. The expansion from anti-TNF to multiple biologic and small molecule classes has transformed care. Discuss trial options with your gastroenterologist.